While I strive to be data-driven in my blogging, I think being a participant in the Tennessee Floods of May, 2010 may have taken the testing of the eHealth paradigm a bit too far. The experience comes with priceless wisdom.
What I’ve personally confirmed:
1) If a heavily residential area loses its landlines, residents will transfer their communication tasks over to the cellular infrastructure, and that infrastructure will likely prove insufficient due to sheer volume of data and voice transmitted. If there is additional capacity which can be brought online, it is not the current practice of the cellular providers to do so, so far as I have been able to ascertain.
2) If cell towers do not have backup electricity generation capability, the cellular network will fail any place the normal electric utility supply is interrupted. It is also possible that local cellular headquarters will require backup electricity generation capability. Since the towers share the public grid, if the power is kept off by the utilities while rubble is inspected and disaster clean up is on-going, this communication outage can continue for some time, or the bandwidth may be severely curtailed. While rural localities can apparently look forward to 4G service in the future, that was of little help to the 42 counties in Tennessee which will be receiving federal disaster relief funds to aid in their rebuilding efforts.
3) Local nonprofits can agree to cooperate in ad hoc manner in a very rapid manner. In the case of Nashville, Hands On Nashville (HON) was chosen to be the task management point by local government, NPOs, houses of worship, private commerce, etc. Thousands of volunteers were coordinated through it.
4) Social media (Facebook, Twitter) was extremely helpful in alerting rescuers about victims needing help, even by persons outside of the disaster areas.
5) A lack of an easy to find/use web cam directory hindered understanding of where water was flooding. Local TV news and radio were able to report well where their crews could reach, and radar covered rain fall, but many areas whose water levels were rising were left uninvestigated. The growth in the number of mobile phones with cameras made citizenship journalism a potential source of reporting.
6) When the elderly and persons with disabilities evacuate (for example, via boat) they often must do so without any of their supportive technology. The UCP Nashville Used Durable Medical Equipment Exchange program is asking for help to replenish so that it can continue to meet the increased calls they are receiving. Coincidentally, HHS recently awarded ARRA funds for a Disability Research Center on Disability Services, Care Coordination and Integration.